The strain of the bacteria E. coli that is spread via romaine lettuce has killed its first victim in what has become a large outbreak that covers 25 states and has struck around 121 victims.

The Department of Public Health of California confirmed a resident has died from the illness linked to contaminated lettuce but cannot say any more, due to patient privacy laws. It did add, however, that the death was one of 24 cases of the illness in the state of California.  

This outbreak, which began around March 13, has the American population avoiding romaine lettuce from the Yuma region of Arizona, a region which produces a large amount of the country’s lettuce in the winter months.

The U.S. Food and Drug Administration, which has been investigating the outbreak along with the Center for Disease Control is investigating the incident and says that it is not linked to Harrison Farms, where the outbreak allegedly originated.

Still, the FDA and the CDC recommend getting rid of all romaine lettuce, home and restaurant alike, unless it is confirmed to not be from the Yuma region and continue to probe the source of the incident.

Most people reported eating a salad at a restaurant and romaine lettuce was the only common ingredient identified among the salads eaten,” the FDA said, according to USA Today. “The restaurants reported using bagged, chopped romaine lettuce to make salads.”

The strain of E. coli infecting people is “toxin producing” according to the CDC and can cause illness 2-8 days after consumption. The E. coli can cause diarrhea, vomiting, and stomach cramps. Although most victims recover within approximately one week, infection can lead to kidney failure.

To prevent spread of the disease, it is recommended to wash hands regularly, cook meat completely, wash all fruits and vegetables thoroughly and not prepare food when sick.